Clinical efficacy of valve-in-valve transcatheter mitral valve replacement for degenerated mitral surgical bioprostheses
- VernacularTitle:经导管瓣中瓣技术治疗二尖瓣外科生物瓣衰败的临床疗效
- Author:
Shixiong WU
1
;
Xu HAN
1
;
Zhikun ZHENG
1
;
Yongkai ZHANG
1
;
Jing XU
1
;
Chen HUANG
1
Author Information
1. Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, P. R. China
- Publication Type:Journal Article
- Keywords:
Valve-in-valve transcatheter mitral valve replacement;
degenerated bioprosthetic valve;
mitral valve replacement;
clinical outcomes
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2026;33(08):1252-1257
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy of valve-in-valve transcatheter mitral valve replacement for the management of degenerated bioprosthetic mitral valves. Methods This study retrospectively analyzed the clinical data of patients who underwent transcatheter mitral valve replacement due to degenerated bioprosthetic mitral valves at the First Affiliated Hospital of Zhengzhou University from 2020 to 2023. The analysis included baseline characteristics, surgical details, perioperative complications, and hemodynamic changes during the early postoperative period and subsequent follow-up. Results A total of 31 patients were included in the study, comprising 7 males and 24 females, with an average age of (66.57±9.32) years. The average duration since the initial surgical placement of the bioprosthetic valves was (9.92±3.71) years. The procedures included 7 patients utilizing the transfemoral venous-atrial septal approach and 24 patients employing the transapical approach. All patients exhibited significant improvement in cardiac function postoperatively, with a reduction in the number of patients classified as New York Heart Association (NYHA) grade Ⅲ or Ⅳ and those with moderate to severe tricuspid valve regurgitation. Echocardiographic assessments revealed a decrease in peak flow velocity across the mitral valve and a reduction in the average transvalvular pressure gradient, while left ventricular ejection fraction remained unchanged. One patient experienced a recurrent stroke and died on the fifth postoperative day; however, the remaining patients were discharged uneventfully, without complications such as cardiac death, left ventricular outflow tract obstruction, or pacemaker implantation. During a median follow-up period of 12 months, no adverse events were reported, and hemodynamic stability was maintained. Conclusion Valve-in-valve transcatheter mitral valve replacement is a safe and effective option for patients with degenerated bioprosthetic mitral valves, demonstrating favorable hemodynamic outcomes and satisfactory short-term clinical results.
